Abstract

Rural residents experience higher disability, mortality, and poverty rates than their urban counterparts; they also have more barriers to accessing care, including nursing home care. Meanwhile, the proportion of nonelderly adult nursing home residents (<65 years old) is growing, yet little is known about this population and barriers they face trying to access care, especially in rural areas. This qualitative study uses data from 23 semistructured interviews with rural hospital discharge planners in five states to identify specific barriers to finding nursing home care for nonelderly rural residents. We grouped those barriers into three primary themes—payment status, fit, and medical complexity—as well as two minor themes—caregivers and bureaucratic processes—and discuss each in the article, along with potential policy and programmatic interventions to improve access to nursing home care for nonelderly rural residents.

Original languageEnglish (US)
Pages (from-to)1708-1727
Number of pages20
JournalJournal of Applied Gerontology
Volume38
Issue number12
DOIs
StatePublished - Dec 1 2019

Bibliographical note

Funding Information:
Henning-Smith Carrie 1 Kozhimannil Katy 1 Prasad Shailendra 1 1 University of Minnesota, Minneapolis, MN, USA Carrie Henning-Smith, Division of Health Policy & Management, School of Public Health, University of Minnesota, 420 Delaware St. SE., Minneapolis, MN 55455, USA. Email: [email protected] 12 2019 38 12 1708 1727 29 6 2017 10 11 2017 14 11 2017 © The Author(s) 2017 2017 Southern Gerontological Society Rural residents experience higher disability, mortality, and poverty rates than their urban counterparts; they also have more barriers to accessing care, including nursing home care. Meanwhile, the proportion of nonelderly adult nursing home residents (<65 years old) is growing, yet little is known about this population and barriers they face trying to access care, especially in rural areas. This qualitative study uses data from 23 semistructured interviews with rural hospital discharge planners in five states to identify specific barriers to finding nursing home care for nonelderly rural residents. We grouped those barriers into three primary themes—payment status, fit, and medical complexity—as well as two minor themes—caregivers and bureaucratic processes—and discuss each in the article, along with potential policy and programmatic interventions to improve access to nursing home care for nonelderly rural residents. rural Medicaid long-term care nursing homes disability Authors’ Note The information, conclusions and opinions expressed in this manuscript are those of the authors and no endorsement by FORHP, HRSA, or HHS is intended or should be inferred. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS) under PHS Grant No. 5U1CRH03717.

Publisher Copyright:
© The Author(s) 2017.

Keywords

  • Medicaid
  • disability
  • long-term care
  • nursing homes
  • rural

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